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Biomedical subjects

D Kaye

Publications and source records attributed to D Kaye.

At least 235 records · Page 13Linked to original sources

The influence of erythrophagocytosis on the interaction of macrophages and salmonella in vitro.

Phagocytosis and killing of Salmonella typhimurium by mouse peritoneal macrophages was inhibited when the bacteria and antibody-coated homologous erythrocytes or heterologous erythrocytes were simultaneously exposed to macrophages in vitro. No inhibition of phagocytosis or killing was observed in experiments employing uncoated or disrupted antibody-coated homologous erythrocytes. Degradation of S. typhimurium as measured by the loss of fluorescence from intracellular salmonella coated with fluorescein-labeled antibody was inhibited in macrophages which had previously ingested antibody-coated homologous erythrocytes. Anti-mouse-erythrocyte serum was found to have a cytotoxic action on mouse macrophages. However, the viability of macrophages was not altered by phagocytosis of antibody-coated homologous erythrocytes or uncoated heterologous erythrocytes.

Animals↗

Effect of splenectomy on the susceptibility of mice inoculated with Diplococcus pneumoniae.

An experimental model is described which demonstrated increased susceptibility of mice to infection with D. pneumoniae following splenectomy. It was necessary to use small numbers of a particular strain of pneumococcus (D. pneumoniae type 6), intravenous infection and a particular strain of mouse (pathogen-free NCS strain). The increase in susceptibility persisted for at least 4 months after splenectomy. With modifications in experimental design such as use of large numbers of organisms, a different strain of pneumococcus, the intraperitoneal route of infection or a different mouse strain no increase or a much less impressive increase in susceptibility was demonstrated. Following intravenous injection of small numbers of D. pneumoniae Type 6 bacteremia tended to persist in all NCS mice. Multiplication of pneumococci subsequently occurred in a higher proportion of mice with splenectomy and at a more rapid rate than in control animals. Mice with splenectomy usually had more D. pneumoniae per ml of blood than per gram of any tissue. This suggested that in these mice multiplication of microorganisms occurs primarily in blood. In control mice higher concentrations of bacteria were present in spleen than in blood, and higher concentrations were found in blood than in other tissues. These results suggested that in normal mice infected intravenously with small numbers of D. pneumoniae Type 6, the spleen protects by removing and killing small but critical numbers of D. pneumoniae which are circulating in the blood. No evidence was found to suggest that the altered susceptibility is mediated by an effect of splenectomy on numbers of circulating leukocytes or on the antibacterial activity of mouse blood.

Animals↗

Effect of bile on the action of blood against Salmonella.

Kaye, Donald (New York Hospital-Cornell Medical Center, New York, N.Y.), Michelle Palmieri, and Heonir Rocha. Effect of bile on the action of blood against Salmonella. J. Bacteriol. 91:945-952. 1966.-Bile is superior to Trypticase Soy Broth (BBL) as a medium for isolation of Salmonella from blood. In addition to inhibitory activity against many of the common bacterial contaminants, bile has the additional advantages of a greater frequency of isolation of Salmonella and more rapid isolation. This study investigated the factors responsible for the superiority of bile. A 20% dilution of normal human blood in Trypticase Soy Broth was usually inhibitory or bactericidal against strains of Salmonella. Similarly, a 20% dilution in Trypticase Soy Broth of serum from patients with Salmonella bacteremia was frequently inhibitory or bactericidal for the salmonellae isolated from their blood. Bile inactivated the bactericidal activity of blood or serum by inactivating complement activity. Bile (13%) in Trypticase Soy Broth inactivated complement activity in 33% blood or serum. Although bile has anticoagulant and hemolytic effects, no evidence was found that these activities contribute to the superiority of bile over Trypticase Soy Broth as a culture medium for Salmonella. No evidence was found for a growth-promoting factor in bile for Salmonella. Bile was much more effective than 0.5 or 2.0% sodium taurocholate broth in inactivating the bactericidal activity of blood.

Antibodies↗

Cefonicid: a long-acting, second-generation cephalosporin. Antimicrobial activity, pharmacokinetics, clinical efficacy and adverse effects.

Cefonicid is a new second-generation cephalosporin with a broad antimicrobial spectrum of activity and a prolonged serum elimination half-life. It has good in vitro activity against methicillin-sensitive Staphylococcus aureus, nonenterococcal streptococci, Hemophilus influenzae, Neisseria gonorrhoeae, Neisseria meningitidis and many of the commonly isolated Enterobacteriaceae. Organisms usually resistant to cefonicid include species of Pseudomonas, Serratia, Acinetobacter and Providencia, and Bacteroides fragilis. The drug is 98% protein bound in human serum, which probably contributes to its significant reduction of antimicrobial activity measured in serum. Limited clinical trials have demonstrated it to be effective for surgical prophylaxis and for treating infections of the urinary tract, lower respiratory tract and bone. Failures have been reported in treatment of soft tissue infections and endocarditis caused by S. aureus. A potential cost reduction may be achieved by administering a single daily dose of cefonicid for established infections or a single preoperative dose for effective surgical prophylaxis instead of multiple-dose regimens of other, similar agents.

Bacteria↗

Therapy for experimental endocarditis due to Staphylococcus epidermidis.

Vancomycin was evaluated with and without gentamicin and/or rifampin in therapy for endocarditis due to methicillin-resistant Staphylococcus epidermidis in rabbits. Vancomycin (30 mg/kg iv every 12 hr), gentamicin (3.5 mg/kg im every 8 hr), rifampin (20 mg/kg im every 12 hr), combinations of vancomycin plus gentamicin, vancomycin plus rifampin, and vancomycin plus gentamicin plus rifampin were injected for two days, and the number of bacteria in vegetations was determined. Ratios of minimal inhibitory concentrations to minimal bactericidal concentrations (microgram/ml) for S. epidermidis were 3.1:25 for vancomycin, 0.2:0.8 for gentamicin, and 0.4:0.4 for rifampin. After two days of therapy, mean log colony-forming units +/- SD in vegetations were 7.1 +/- 1.5 (none of eight animals were sterile) for vancomycin; 4.6 +/- 2.2 (two of nine) for gentamicin; 4.5 +/- 2.2 (two of eight) for rifampin; 3.3 +/- 1.3 (three of 10) for vancomycin plus gentamicin; 2.7 +/- 1.2 (three of nine) for vancomycin plus rifampin; 2.1 +/- 0.2 (eight of nine) for vancomycin plus gentamicin plus rifampin; and 8.1 +/- 1.3 (none of 12) for the control group. Gentamicin, rifampin, vancomycin plus gentamicin, and vancomycin plus rifampin were significantly more effective than was vancomycin; vancomycin plus rifampin was more effective than was gentamicin alone; and the combination of vancomycin plus gentamicin plus rifampin was more effective than were the drugs administered alone or in the combinations vancomycin plus gentamicin and vancomycin plus rifampin. Two days of treatment followed by seven days of no treatment resulted in 71%, 29%, and 14% sterile vegetations in rabbits receiving the combination therapy vancomycin plus gentamicin plus rifampin, vancomycin plus rifampin, and vancomycin plus gentamicin, respectively.

Animals↗

An overview: evaluation of cefonicid in infections of the urinary tract, lower respiratory tract, and skin and soft tissue.

Infections of the urinary and lower respiratory tracts and of skin and soft tissue constitute a large proportion of infections requiring antimicrobial therapy. For many antimicrobial agents, one dose will cure lower urinary tract infection. In contrast, relapse of upper tract infection is common even after two weeks of treatment. In comparing the efficacy of antimicrobial agents in urinary infection, it is critical that patients assigned to different agents be equivalent. The questions about cefonicid in urinary infection that must be addressed concern (1) adverse effects and tolerability, (2) cost, and (3) rationale for the use of a parenteral preparation in uncomplicated urinary infection. In lower respiratory tract infections, therapeutic efficacy is difficult to evaluate primarily because of the difficulty in determining the causative role of the organisms isolated from sputum. The inclusion of information from gram-stained preparations reduces the diagnostic error. As far as cefonicid in treatment of pneumonia is concerned, the high serum protein binding reported and the relatively high minimal inhibitory concentrations for gram-positive cocci must be addressed. In skin and soft-tissue infections, therapeutic efficacy is difficult to evaluate because of the lack of isolates and the self-limited nature of many cutaneous infections.

Bacterial Infections↗

Single-dose regimen of cefonicid for the treatment of uncomplicated infections of the lower urinary tract.

Fifty-three women with symptoms of lower urinary tract infection were randomly assigned to treatment with cefonicid administered intramuscularly in a single 1-g dose or to treatment with 500 mg of amoxicillin administered orally three times a day for five to seven days. Urine cultures were obtained before therapy and again at five to 18 days and six to seven weeks after termination of therapy. Forty-one patients had greater than or equal to 2 X 10(4) colony-forming units (cfu)/ml of catheterized urine or greater than or equal to 10(5) cfu/ml of midstream urine. In the cefonicid-treated group, 19 (90%) of 21 patients demonstrated bacteriologic cure at early follow-up. Of the 18 patients seen at late follow-up, 15 were cured and three were reinfected. One patient was lost to late follow-up. In the amoxicillin-treated group, 16 (80%) of 20 patients demonstrated bacteriologic cure at early follow-up. Of the 15 patients available at late follow-up, 14 were cured and one was reinfected. One patient was lost to late follow-up. Cefonicid is an effective single-dose agent in uncomplicated lower urinary tract infection.

Adult↗

Multicenter study of the clinical efficacy of imipenem/cilastatin for treatment of serious infections.

The efficacy and safety of imipenem/cilastatin was evaluated in a multicenter study. For 49 of the 78 patients with 79 infections entered into the study, the clinical and bacteriologic efficacy of therapy could be evaluated. Toxicity data were analyzed for all 79 infections. Overall, 35 of 49 infections were cured or improved: 10 of 11 cases of pneumonia; 8 of 15 cases of pyelonephritis; 4 of 5 cases of osteomyelitis; 3 of 4 intravascular infections; 6 of 9 soft tissue infections; and 4 of 5 miscellaneous infections. There were 13 bacteriologic failures; superinfections with resistant organisms (i.e., Candida albicans, methicillin-resistant Staphylococcus epidermidis, and Pseudomonas maltophilia) occurred in three patients; reinfection with sensitive pathogens complicated one urinary tract infection; relapses developed of five urinary tract infections and of one case of endarteritis; and bacteriologic persistence occurred in three soft tissue infections. Infections with Pseudomonas aeruginosa were the most difficult to treat. In only six of 11 P. aeruginosa infections was both bacteriologic and clinical cure achieved. Adverse effects were minimal; no serious hematologic or hepatic toxicity and no adverse renal effects were noted.

Adult↗